Test GST Registration Page

Parent/Guardian Details

Primary Contact*

Parent/Guardian 1/Adult Member

Name of Parent/Guardian 1*

First Last

Mobile*

Email*

Enter Email Confirm Email

Home Phone

Address*

Unit/House Number Street Name Suburb Post Code

Municipality*

Please nominate which Municipality you reside

Parent/Guardian 1 (Optional)

Name of Parent/Guardian 1

First Last

Mobile

Email

Enter Email Confirm Email

Home Phone

Address

Unit/House Number Street Name Suburb Post Code

Parent/Guardian 2

Parent/Guardian 2 Name*

First Last

Mobile*

Email*

Enter Email Confirm Email

Home Phone

Address*

Unit/House Number Street Name Suburb Post Code

Municipality*

Please nominate in which Municipality you reside*

Parent/Guardian 2 (Optional)

Parent/Guardian 2 Name

First Last

Mobile

Email

Enter Email Confirm Email

Home Phone

Address

Unit/House Number Street Name Suburb Post Code

request the Caulfield Malvern Basketball Club Inc to enrol my child/children as new players

Player 1 Details

Player 1 Name*

First Last

Preferred Name

(Optional)

Player 1 Date of Birth*

DD

MM

YYYY

Which Age Group does Player 1 intend to play in?*

U8, U10, U12, U14, U16 or U18
U23 Only

Player 1 Male or Female*

Player 1 Current School*

Please specify which school your child attends*

Player 1 Current School Year*

Player 1 Comments

e.g. Any information that may be useful in placing the player in a team

Player 1 Mobile

(Optional)

Player 1 Payment CODE

Enter CODE if previously advised

Player 1 - Agreed Subscription fee (inclusive of GST)*

Enter Agreed Subscription Fee (note this is inclusive of all weekly sheet fees)

Player 1 - Regular Subscription Fee (inclusive of GST)

(note this is inclusive of all weekly sheet fees)

Price: $ 240.00

Player 1 - U23 Player Subscription Fee (inclusive of GST)

(note this is inclusive of all weekly sheet fees)

Price: $ 180.00

Enter Second Player?*

No
Yes

Player 2 Details

Player 2 Name*

First Last

Preferred Name

(Optional)

Player 2 Date of Birth*

DD

MM

YYYY

Which Age Group does Player 2 intend to play in?*

U8, U10, U12, U14, U16 or U18
U23 Only

Player 2 Male or Female*

Player 2 Current School*

Please specify which school your child attends*

Player 2 Current School Year*

Player 2 Comments

e.g. Any information that may be useful in placing the player in a team

Player 2 Mobile

(Optional)

Player 2 Payment CODE

Enter CODE if previously advised

Player 2 - Agreed Subscription Fee (inclusive of GST)*

Enter Agreed Subscription Fee (note this is inclusive of all weekly sheet fees)

Player 2 - Regular Subscription Fee (inclusive of GST)

(note this is inclusive of all weekly sheet fees)

Price: $ 240.00

Player 2 - U23 Player Subscription Fee (inclusive of GST)

(note this is inclusive of all weekly sheet fees)

Price: $ 180.00

Enter Third Player?*

No
Yes

3rd Player Details

Player 3 Name*

First Last

Preferred Name

(Optional)

Player 3 Date of Birth*

DD

MM

YYYY

Which Age Group does Player 3 intend to play in?*

U8, U10, U12, U14, U16 or U18
U23 Only

Player 3 Male or Female*

Player 3 Current School*

Please specify which school your child attends*

Player 3 Current School Year*

Player 3 Comments

e.g. Any information that may be useful in placing the player in a team

Player 3 Mobile

(Optional)

Player 3 Payment CODE

Enter CODE if previously advised

Player 3 - Agreed Subscription Fee (inclusive of GST)*

Enter Agreed Subscription Fee (note this is inclusive of all weekly sheet fees)

Player 3 - Regular Subscription Fee (inclusive of GST)*

(note this is inclusive of all weekly sheet fees)

Price: $ 240.00

Player 3 - U23 Player Subscription Fee (inclusive of GST)*

(note this is inclusive of all weekly sheet fees)

Price: $ 180.00

Authorisation

Terms and Conditions*

Have you read and do you accept the terms and conditions. Click here to view T&C

Accept

Uniform

If you require a uniform please visit the Uniform Shop on the website.

Payment Details

Total Subscription Fees

Please do not close your window (after pressing Submit) before receiving a confirmation message.

$ 0.00

Total Subs Calc

Credit Card*

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Phone

This field is for validation purposes and should be left unchanged.

Test GST Registration Page

Summer 2019 Season - New Member Application

Parent/Guardian Details

Parent/Guardian 1/Adult Member

Parent/Guardian 1 (Optional)

Parent/Guardian 2

Parent/Guardian 2 (Optional)

Player 1 Details

Player 2 Details

3rd Player Details

Authorisation

Uniform

If you require a uniform please visit the Uniform Shop on the website.

Payment Details

Title

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